Healthcare Provider Details

I. General information

NPI: 1215967278
Provider Name (Legal Business Name): KIMBERLY E GERARDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 S BEDFORD ST
GEORGETOWN DE
19947-1852
US

IV. Provider business mailing address

PO BOX 30170
WILMINGTON DE
19805-7170
US

V. Phone/Fax

Practice location:
  • Phone: 302-856-5135
  • Fax:
Mailing address:
  • Phone: 302-623-7019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License NumberL10000107
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0000115
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: